Family Information
Students will receive a grade based on your completion of this form!
Parent/Guardian(s) Full Name
Your answer
Parent/Guardian(s) Relationship to student
Your answer
Student First Name(s)
Your answer
Student Last Name(s)
Your answer
Primary email
Your answer
Primary phone
Your answer
Preferred type of contact
Does your student have any allergies that I should know about (food and latex in particular)?
Your answer
Does your student have any behavior or emotional concerns that I should be aware of?
All information provided will be kept confidential!
Your answer
How would you rate the type of internet access that your student has at home?
Check any that apply, or explain your personal situation in the "other" section.
What was your student's average science grade last year?
Do you have any other comments, questions, concerns, or advice pertaining to helping your student achieve success in this course?
Your answer
Student's Class Period
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